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Background: Despite unprecedented socio-economic growth experienced by Indians in the past few decades, and a long history of anti-anaemia public health measures, prevalence of anaemia in Indian non-pregnant women of reproductive age group (NPWRA) has not declined. This warrants a firm understanding of what explains the anaemia situation over time, preferably by sub-populations. Therefore, we aimed to examine the trends of anaemia in tribal NPWRA (least privileged) and compare with the trends in the NPWRA of general caste (most privileged) between 1998 to 2021. Additionally, the study also explored explanation of any decline and tribal/general narrowing of these trends. Methods: We studied four rounds of National Family Health Survey (1998–99, 2005–06, 2015–16, 2019–21). We examined the trend of anaemia (haemoglobin < 12 g/dl) and its possible determinants in tribal and general NPWRA and estimated the portion of "decline" and "narrowing" that could be explained by the underlying and intermediate determinants (wealth, education, residence, parity and food security) using multiple logistic regression. Results: The distribution of determinants improved over 23 years in both the groups but more in tribals. But anaemia either remained unchanged or increased in both except 7.1 points decline in tribals between 2006–2016, leading also to 7 points narrowing of tribal/general gap. The modest attenuation of beta coefficients representing the change of anaemia prevalence (log of odds) in tribals from -0.314(-0.377, -0.251) to -0.242(-0.308, -0.176) after adjustment with determinants could explain only 23% of the decline. Similarly, only 7% of the narrowing of the tribal/general anaemia gap could be explained. Conclusions: The structural determinants wealth, education, food security, parity and urban amenities improved immensely in India but anaemia did not decline in this 23-year period. This implies that the "usual suspects" – the structural determinants are not the main drivers of anaemia in the country. The main driver may be absolute and/or functional deficiency status of micronutrients including iron attributable to inadequate uptake and absorption of these elements from Indian diets; and therefore, their effects are noticeable in every socio-economic stratum of India. Future research for aetiologies and new interventions for anaemia alleviation in India may focus on these factors. [ABSTRACT FROM AUTHOR]

The early detection of anaemia is important for its subsequent control and incidence among women of childbearing age. This study aimed to assess the anaemia status of preconception young married women in India using National Family Health Survey-4 data collected in 2015–16. A total 65,238 sample preconception young married women were analysed using univariate, bivariate and multivariate techniques. A majority belonged to the Hindu religion (81.7%), lived in rural areas (64.5%) and had secondary level education (51.8%), and 41.7% had not yet given birth. The percentage suffering from anaemia was 51.3%. The prevalence of anaemia was higher among younger women (55.3%), those from Scheduled Tribes (59.0%), those living in rural areas (52.8%), the non-educated (55.9%), those in the poorest wealth quintile (56.9%), those from the East region (57.0%) and those with a low body mass index (BMI) (58.4%). The adjusted odds ratios indicated that, after controlling for significant background factors, Hindu, Scheduled Tribe, Scheduled Caste, East region, already having a child, too thin for their height and poorer and poorest wealth quintiles had higher odds of suffering from anaemia compared with the reference groups. The odds of suffering from anaemia decreased with age and education. The study showed a high burden of anaemia and associated risk factors among preconception young married women in India. The finding will inform decision-makers when planning interventions to decrease anaemia among women of childbearing age in India. [ABSTRACT FROM AUTHOR]